Abstract: Objective To observe the safety of therapeutic plasma exchanges （TPE） in patients with critical diseases such as hematologic，neurologic，and metabolic disorders. Method Data of therapeutic plasma exchanges were collected in patients from Oct 2012 to Dec 2017. Detailed information of adverse events were recorded. Blood cell loss，hemolysis and changes of antibody titers were measured. Result Sixty-eight patients received 262 TPE treatments. Among them，33.8 percent of the patients were seen to have TPE related complications，with 16.8 percent of complication occurrence. After corresponding treatments，the adverse reactions were remitted immediately and follow-up treatments were completed. Blood loss of each TPE session was less than 1% of the patient’s total blood volume. No obvious hemolysis was noted in waste plasma bag. The maximum decrease in HBsAb was achieved on the final day of TPE sessions （70-80% reduction）. A slow return to baseline for HBsAb was observed. Conclusion The majority of complications were mild and manageable. The TPE may not cause obvious blood loss and hemolysis. HBsAb was detectable during the treatment. The TPE is a safe and well tolerated treatment option in several illnesses.

Key words: Therapeutic plasma exchanges , Adverse events , Safety